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Sep 6, 2011
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  1. Medical Student

So whilst I have no problems understanding anddifferentiating the different types of acidosis and alkalosis, I can’t grasphow the renal system responds to acid/base problems at the molecular level. Anyone care to help me out?

Kidneys respond to acidosis in 2 ways:

- HCO3- Reabsorption:

o H2CO3 is converted toH2CO3, H2O and CO2 in the tubules and H2CO3 and CO2 is reabsorbed. Surely thisisn’t only recycling, but in fact proton secretion as two H+ are excreted in H2O?

o H2CO3 is converted to H+and HCO3-, the H+ is buffered by another anion, namely NH3 from NH4+ from theconversion of Glutamine to Glutamate. The HCO3- is absorbed. Here, if NH4+ iscreated from Glutamine, and NH4+ is what is excreted in urine, surely there isno net H+ excretion?
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